Reducing antibiotic prescribing in primary care: results from the REDUCE trial

13 February 2019

A cluster randomised trial aiming to reduce unnecessary antibiotic prescribing, led by King’s College London and supported by CPRD, has published its results. The year-long trial took place between 2016-17 and focused on antibiotic prescribing for respiratory tract infection (RTI) patients.

The trial included 79 CPRD general practices from throughout the UK, with the anonymised data of over half a million patients being analysed. Practices were randomised to control or intervention arms, with those in the intervention arm receiving an antimicrobial stewardship intervention including a short training webinar, access to decision support tools and monthly prescribing feedback reports. The tools included information sheets for patients, providing information on self-care and how they might deal with their symptoms without use of antibiotics.

Results showed a 16% reduction in antibiotic prescribing for RTI in 15-84 year olds compared to control practices and a 12% overall reduction for all ages. An accompanying population cohort analysis of safety outcomes from over 45 million patient lives, from CPRD contributing GP practices that did not receive the intervention, demonstrated that there was no increased bacterial infection risk for RTIs by reducing antibiotic prescribing in primary care.

The full results are published in the BMJ here (Gulliford et al. BMJ 2019;364:l236)

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